The Concept for A Standalone Lordotic Endoscopic Wedge Lumbar Interbody Fusion: The LEW-LIF
Objective To review concepts of a standalone endoscopically assisted lumbar interbody fusion as a simplified method to treat spinal instability. Methods MacNab outcomes and complications were analyzed in a series of 48 consecutive patients who underwent standalone lordotic endoscopic wedge lumbar in...
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| Format: | Article |
| Language: | English |
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Korean Spinal Neurosurgery Society
2019-03-01
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| Series: | Neurospine |
| Subjects: | |
| Online Access: | http://www.e-neurospine.org/upload/pdf/ns-1938046-023.pdf |
| _version_ | 1797333181529063424 |
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| author | Kai-Uwe Lewandrowski Nicholas A. Ransom Jorge Felipe Ramírez León Anthony Yeung |
| author_facet | Kai-Uwe Lewandrowski Nicholas A. Ransom Jorge Felipe Ramírez León Anthony Yeung |
| author_sort | Kai-Uwe Lewandrowski |
| collection | DOAJ |
| description | Objective To review concepts of a standalone endoscopically assisted lumbar interbody fusion as a simplified method to treat spinal instability. Methods MacNab outcomes and complications were analyzed in a series of 48 consecutive patients who underwent standalone lordotic endoscopic wedge lumbar interbody fusion (LEW-LIF) for advanced lumbar disc degeneration, spinal stenosis, and spondylolisthesis. Results Forty-two of the 48 patients (77.8%) did well with excellent and good outcomes with a follow up of up to 20 months. Fair outcomes were reported by 4, and poor by another 2 patients, respectively. Six patients had endoscopic decompression procedures at another level. Four patients underwent open transforaminal lumbar interbody fusion revision surgery including the index level between 2 to 6 months postoperatively. An L5 vertebral body fracture was noted in 1 of these 4 patients. Another patient underwent removal of the extruded L3/4 cage. The cage fractured in one additional asymptomatic patient not requiring any intervention. No patient had a wound infection, or permanent sensory, or motor dysfunction. However, 29 patients developed a postoperative irritation of the dorsal root ganglion with burning leg pain typically between postoperative weeks 2 and 6. Symptoms were treated with activity modification, gabapentin, and transforaminal epidural steroid injections in 12 patients (25%). Conclusion Standalone LEW-LIF was associated with favorable clinical outcomes in the majority of patients. Patient-related predictors of less favorable outcomes considering normal variations as well as patho-anatomy may aid in the development of next-generation implants. |
| first_indexed | 2024-03-08T08:00:03Z |
| format | Article |
| id | doaj.art-ce33762ebe384fd3acc973d17f74371a |
| institution | Directory Open Access Journal |
| issn | 2586-6583 2586-6591 |
| language | English |
| last_indexed | 2024-03-08T08:00:03Z |
| publishDate | 2019-03-01 |
| publisher | Korean Spinal Neurosurgery Society |
| record_format | Article |
| series | Neurospine |
| spelling | doaj.art-ce33762ebe384fd3acc973d17f74371a2024-02-02T12:40:25ZengKorean Spinal Neurosurgery SocietyNeurospine2586-65832586-65912019-03-01161829510.14245/ns.1938046.023847The Concept for A Standalone Lordotic Endoscopic Wedge Lumbar Interbody Fusion: The LEW-LIFKai-Uwe Lewandrowski0Nicholas A. Ransom1Jorge Felipe Ramírez León2Anthony Yeung3 Center for Advanced Spine Care of Southern Arizona, Surgical Institute of Tucson, Tucson, AZ, USA Surgical Institute of Tucson, Tuscon, AZ, USA Fundación Universitaria Sanitas, Bogotá, D.C., Colombia Department of Neurosurgery, University of New Mexico School of Medicine, Albuquerque, NM, USAObjective To review concepts of a standalone endoscopically assisted lumbar interbody fusion as a simplified method to treat spinal instability. Methods MacNab outcomes and complications were analyzed in a series of 48 consecutive patients who underwent standalone lordotic endoscopic wedge lumbar interbody fusion (LEW-LIF) for advanced lumbar disc degeneration, spinal stenosis, and spondylolisthesis. Results Forty-two of the 48 patients (77.8%) did well with excellent and good outcomes with a follow up of up to 20 months. Fair outcomes were reported by 4, and poor by another 2 patients, respectively. Six patients had endoscopic decompression procedures at another level. Four patients underwent open transforaminal lumbar interbody fusion revision surgery including the index level between 2 to 6 months postoperatively. An L5 vertebral body fracture was noted in 1 of these 4 patients. Another patient underwent removal of the extruded L3/4 cage. The cage fractured in one additional asymptomatic patient not requiring any intervention. No patient had a wound infection, or permanent sensory, or motor dysfunction. However, 29 patients developed a postoperative irritation of the dorsal root ganglion with burning leg pain typically between postoperative weeks 2 and 6. Symptoms were treated with activity modification, gabapentin, and transforaminal epidural steroid injections in 12 patients (25%). Conclusion Standalone LEW-LIF was associated with favorable clinical outcomes in the majority of patients. Patient-related predictors of less favorable outcomes considering normal variations as well as patho-anatomy may aid in the development of next-generation implants.http://www.e-neurospine.org/upload/pdf/ns-1938046-023.pdfSpinal diseasesEndoscopySpinal fusion |
| spellingShingle | Kai-Uwe Lewandrowski Nicholas A. Ransom Jorge Felipe Ramírez León Anthony Yeung The Concept for A Standalone Lordotic Endoscopic Wedge Lumbar Interbody Fusion: The LEW-LIF Neurospine Spinal diseases Endoscopy Spinal fusion |
| title | The Concept for A Standalone Lordotic Endoscopic Wedge Lumbar Interbody Fusion: The LEW-LIF |
| title_full | The Concept for A Standalone Lordotic Endoscopic Wedge Lumbar Interbody Fusion: The LEW-LIF |
| title_fullStr | The Concept for A Standalone Lordotic Endoscopic Wedge Lumbar Interbody Fusion: The LEW-LIF |
| title_full_unstemmed | The Concept for A Standalone Lordotic Endoscopic Wedge Lumbar Interbody Fusion: The LEW-LIF |
| title_short | The Concept for A Standalone Lordotic Endoscopic Wedge Lumbar Interbody Fusion: The LEW-LIF |
| title_sort | concept for a standalone lordotic endoscopic wedge lumbar interbody fusion the lew lif |
| topic | Spinal diseases Endoscopy Spinal fusion |
| url | http://www.e-neurospine.org/upload/pdf/ns-1938046-023.pdf |
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